Circulating Tumor Cells (CTCs) or Cancer Stem Cells (CSCs): The Unresolved Paradox as Drivers of Metastasis
Journal Title: GUJARAT CANCER SOCIETY RESEARCH JOURNAL - Year 2016, Vol 18, Issue 1
Abstract
Summary Tumor aggressiveness, relapse and metastasis are the primary causes of poor survival rates in patients with advanced stage cancer despite successful resection as well as chemotherapeutic treatment which limits the possibility of developing new therapeutic strategies. Nevertheless, circulating tumor cells (CTCs), accountable for tumor dissemination, and cancer stem cells (CSCs), essential for tumor growth maintenance, together shed light on the complex metastatic cascade. The major cause of recurrence and metastasis can be attributed to the cancer stem cells (CSCs), which are extremely resistant to chemotherapy. Moreover, CTCs and CSCs are not essentially separate subpopulations of tumor cells, because CTCs are essentially generated in the process of epithelial mesenchymal transition (EMT) and often have features characteristic of CSCs. Furthermore, EMT programming in tumor cells allows the remodelling of extracellular matrix to break the dormancy of relapse-initiating CSCs. Thus, in this review we comprehensively discuss the association of EMT with CTCs and CSCs to characterize a subpopulation of patients prone to recurrence, relapse and metastasis. Deeper understanding of the mechanisms by which EMT-transformed CTCs and CSCs initiate relapse could aid in the development of new strategies for early detection of metastasis and treatment approaches that will be translated into clinical practice.
Authors and Affiliations
Kanisha Shah, Sheefa Mirza, Shanaya Patel, Rakesh Rawal
Keywords
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